Understand the Ovarian Cancer

Ovarian cancer is characterized by malignant cells in the ovaries. One located on each side of the uterus, the small, almond-shaped ovary is an organ that stores eggs or germ cells and produces the female hormones estrogen and progesterone.

 

More than-thirty different types of ovarian cancer are categorized by the type of cells where the malignancy begins:

 

  • Epithelial ovarian cancers account for about 80%–90% of ovarian cancers; the tumors originate in the surface epithelial tissue (the lining on the outside of the ovary). Epithelial ovarian cancer can be subdivided into histologic cell types, which include serous, mucinous, endometrioid, clear cell, transitional, and undifferentiated carcinomas. The risk of epithelial ovarian cancer increases with age, especially after the age of 50.
 
  • Germ Cell tumors account for approximately 10%–15% of all ovarian cancers and originate in the egg-producing cells within the ovary. This type of ovarian cancer can occur in women of any age, but approximately 80% are diagnosed in women under the age of 30.
 
  • Sex Cord Stromal tumors account for about 5%–10% of all ovarian cancers and are generally less aggressive than other ovarian tumors. These tumors develop in the connective tissue that holds the ovary together and that produces the female hormones (estrogen and progesterone); they may appear in any age group, with more cases diagnosed in patients between the ages of 40 to 50 years.

 

Ovarian cancer is difficult to detect, especially in the early stages. This is partly because these organs are deep within the abdominal cavity, one on each side of the uterus.

 

Potential signs and symptoms of ovarian cancer often include:


  • Pelvic or abdominal pain or discomfort
  • Pelvic and/or abdominal swelling, bloating and/or feeling of fullness
  • Vague but persistent gastrointestinal upsets such as gas, nausea, and indigestion which increase over time
  • Ongoing unusual fatigue

 

Less common symptoms include:


  • Frequency and/or urgency of urination in the absence of an infection
  • Unusual vaginal bleeding
  • Shortness of breath

 

Ovarian cancer can sometimes be associated with known risk factors for the disease. Many risk factors are modifiable, though not all can be avoided.

 

Factors which may increase risk of developing ovarian cancer:

 

  • Age: The risk of developing ovarian cancer increases as a woman gets older. Most women are over 55 when diagnosed with ovarian cancer.
 
  • Family or personal history of ovarian cancer: A woman whose mother or sister has had ovarian cancer has a higher than average risk of developing ovarian cancer.
 
  • Never being pregnant: Older women who have never been pregnant have an increased risk of developing ovarian cancer.
 
  • Hormone Replacement Therapy/Hormone Therapy may be associated with an increased risk of ovarian cancer in postmenopausal women.
 
  • Behavioral factors: Other risk factors that have been suggested for ovarian cancer are the use of fertility drugs, the use of talcum powder in the area between the vagina and the anus and being obese. The exact relationship remains unclear.

 

The table below lists the stages of epithelial ovarian cancer.

 

STAGING OF EPITHELIAL OVARIAN CANCER 

 

Stage

Definition

Stage I

Is found in one or both of the ovaries and has not spread

IA

Cancer is found in a single ovary

IB

Cancer is found in both ovaries but doesn’t penetrate to the outside

IC

Cancer is found in one or both ovaries and one of the following is true:

  • · cancer is found on the outside surface of one or both ovaries; or
  • · the capsule (outer covering) of the tumor has ruptured (broken open); or
  • · cancer cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal cavity)

Stage II

Cancer is found in one or both ovaries and has spread into other areas of the pelvis

IIA

Cancer has spread to the uterus and/or the fallopian tubes (the long slender tubes through which eggs pass from the ovaries to the uterus)

IIB

Cancer has spread to other tissue within the pelvis

IIC

Cancer has spread to the uterus and/or fallopian tubes and/or other tissue within the pelvis and cancer cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal cavity)

Stage III

Cancer is found in one or both ovaries and has spread to other parts of the abdomen. Stage III is divided into stage IIIA, stage IIIB, and stage IIIC.

Cancer that has spread to the surface of the liver is also considered stage III disease.

IIIA

The tumor is found only in the pelvis, but cancer cells have spread to the surface of the peritoneum (tissue that lines the abdominal wall and covers most of the organs in the abdomen), though they are so small they can only be seen under a microscope

IIIB

Cancer has spread to the peritoneum but is 2 centimeters or smaller in diameter

IIIC

Cancer has spread to the peritoneum and is larger than 2 centimeters in diameter and/or has spread to lymph nodes in the abdomen

Stage IV

Cancer is found in one or both ovaries and has metastasized (spread) beyond the abdomen to other parts of the body. Cancer is found in the tissues of the liver.

Recurrent

Recurrent ovarian epithelial cancer is cancer that has recurred (come back) after it has been treated. Persistent cancer is cancer that does not go away with treatment.